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General NPI Number Information
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NPI Number | 1679962393
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Entity Type | Organization
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Legal Business Name | YOU ARE WORTHY, INC
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 01/19/2015
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Provider Practice Location Address
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Address Line | 2801 BUFORD HWY NE SUITE T30
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2149
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Country | US
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Telephone | 678-856-5031
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 BUFORD HWY NE SUITE T30
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2149
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Country | US
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Telephone | 678-856-5031
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JD JACKSON
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Credential | LPC
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Telephone | 678-856-5031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007193
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License Number State | GA
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